Abstract :
Supraventricular tachycardia (SVT) is the most common tachyarrhythmia in neonates with incidence varying from 1 in every 250-1000 pediatric patients. Atrioventricular re-entrant tachycardia utilizing an atrioventricular bypass tract is the most common form of SVT in the neonatal period. It is a condition requiring emergency care and cardiac monitoring. Case description: This case report is on a term male newborn diagnosed with SVT at birth. The baby had tachycardia (>220/min) with ECG suggesting SVT. Rhythm reverted to normal with peri-ocular ice pack application during the first episode. On subsequent monitoring for the next 5 days, the baby didn’t have arrhythmias. On day 11 follow-up, the baby had SVT and was treated with periocular ice pack application, Inj. Adenosine, Inj. Diltiazem, Inj. Amiodarone sequentially for which SVT was resistant. Baby responded to oral flecainide and was discharged on the same. At 1 month review, baby was accepting feeds well, with adequate weight gain and heart rate maintaining between 120-130/min with normal rhythm, continued flecainide. Baby was under regular follow-up in pediatric cardiology and started on propranolol and flecainide. Serial ECG and echocardiogram were normal. Currently, baby is 2.5 years old, developmentally normal, hemodynamically stable and on drugs propranolol and flecainide. Conclusion: In recent years, Flecainide has been used effectively in fetal and neonatal SVTs.
Keyword :
Intensive care, Arrhythmias, Cardiovascular medicine, Neonatal intensive care